Healthcare Provider Details

I. General information

NPI: 1740457431
Provider Name (Legal Business Name): CICLEY ANGELA AUGUSTIN-MACHULSKI R.N.,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 S CONGRESS AVE
WEST PALM BEACH FL
33409-3823
US

IV. Provider business mailing address

2495 WESTMONT LN
ROYAL PALM BEACH FL
33411-6137
US

V. Phone/Fax

Practice location:
  • Phone: 561-640-0013
  • Fax: 561-471-1966
Mailing address:
  • Phone: 561-753-9571
  • Fax: 561-753-9571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 9215547
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: